Let's start. Registration takes 2 minutes.
Registrations for ages 9 to 11.
Register Now
 
Where are you attending the program? *


 
PARENT DETAILS

Let's start by collecting all your details so we can communicate with you.
 
Parent's First Name *

 
Parent's Last Name *

 
{{answer_27575201}}, what's your mobile number? *

 
CHILD DETAILS

Now, let's complete all the detail about the participant.
 
Child's First Name: *

 
Child's Last Name: *

 
What is {{answer_27575204}} gender? *




 
What is{{answer_27575204}} date of birth? *

 
And {{answer_27575204}}'s age today? *

 
Has {{answer_27575204}}received a formal diagnosis? *

For examples Anxiety, ADHD, ASD, etc

 
Please provide more details about the diagnosis. *

Please note that the workshop may not be suitable to {{answer_27575204}}.
 
Payment and Terms and Conditions

 
{{answer_27575201}} please review and agree the terms and conditions.

By clicking I accept, you agree to our terms and conditions details available at: http://help.quirkykid.com.au/category/15-billing-terms-and-policies. Our workshops and programs have an additional list of terms available at: http://help.quirkykid.com.au/article/19-terms-and-conditions-workshops
     
 
The total price for the 10-week program {{var_price}} *

The EARLYBIRD price per session is now $83.70 and this includes all materials and parent interview and feedback session. Normal price is $93 per session.
 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


{{answer_27575201}} well done. {{answer_27575204}} is now registered!